Neuroprotection SIG

SIG Corner Editor: João Barbosa Breda

Chair: Francesca Cordeiro Co-chair: Miriam Kolko
The goal of this SIG is to increase ophthalmologists’ knowledge on XFS and XFG, and to support the optimal clinical care in XFG in Europe.

1. Update on the SIG ongoing projects

The neuroprotection SIG forms the basis of symposia, “tips of the month”, and puts neuroprotection on the map of important issues in glaucoma. Please join the online neuroprotection SIG at the upcoming virtual EGS meeting!

2. Relevant breakthroughs in the field

The first promising results come from clinical trials testing the vitamin B3 component, niacin. Niacin is currently the most promising neuroprotective treatment target in glaucoma. Read more in this interesting paper below.

Improvement in inner retinal function in glaucoma with nicotinamide (vitamin B3) supplementation: A crossover randomized clinical trial.
Hui F, Tang J, Williams PA, McGuinness MB, Hadoux X, Casson RJ, Coote M, Trounce IA, Martin KR, van Wijngaarden P, Crowston JG. Clin Exp Ophthalmol. 2020 Sep;48(7):903-914. doi: 10.1111/ceo.13818. Epub 2020 Jul 28.PMID: 32721104

Glaucoma leads to dendritic retraction and synapse loss that precede retinal ganglion cell death. In a recent study by Agostinone et al., human recombinant insulin, administered as eye drops or systemically in a mouse model with axonal injury promoted robust regeneration of dendrites and successful reconnection with presynaptic targets. Axotomy-induced dendrite retraction was shown to trigger substantial loss of the mammalian target of rapamycin (mTOR) activity exclusively in retinal ganglion cells, and Insulin was shown to fully reverse this response. The findings demonstrate that neurons in the mammalian central nervous system have the intrinsic capacity to regenerate dendrites and synapses after injury, and provide a strong rationale for the use of insulin as pro-regenerative therapeutics for intractable neurodegenerative diseases such as glaucoma.

Insulin signalling promotes dendrite and synapse regeneration and restores circuit function after axonal injury.
Agostinone J, Alarcon-Martinez L, Gamlin C, Yu WQ, Wong ROL, Di Polo A. Brain. 2018 Jul 1;141(7):1963-1980.

The search for EGS goal of “Paving the Way to Better Glaucoma Care” continues together with Outcome and other EGS Committees as well as SIGs, i.e. how to promote the best possible well-being and minimal glaucoma-induced visual disability in individuals with glaucoma within affordable healthcare systems. The views expressed are those of the author(s) and are not necessarily those of the EGS.